In this month’s issue of Pediatrics, the article titled “Preschool ADHD Diagnosis and Stimulant Use Before and After the 2011 AAP Practice Guideline”1 makes use of the aggregate of electronic medical records (EMRs) from multiple programs to investigate the effect of guideline recommendations on the practice of pediatricians. It is an innovative process that can provide more rigorous information about moving evidence into practice. It is encouraging for those of us who worked on crafting the revised guidelines to find some evidence about the impact of those recommendations.
However, as the investigators point out, although they were able to find out that in preschool-aged children with attention-deficit/hyperactivity disorder (ADHD), recommended criteria for the use of stimulant medications, specifically methylphenidate, did not result in an increase in its use in this age group, the frequency of behavioral parent training, the first-line recommended treatment,2 could not be determined. The...
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